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OBJECTIVE: To verify the involvement of the endocannabinoid system in the immunomodulatory profile of stem cells from human exfoliated deciduous teeth, in the presence or absence of TNF-α, and agonist and antagonists of CB1 and CB2. METHODS: Stem cells from human exfoliated deciduous teeth were cultured in the presence or absence of an agonist, anandamide, and two antagonists, AM251 and SR144528, of CB1 and CB2 receptors, with or without TNF-α stimulation. For analysis of immunomodulation, surface molecules linked to immunomodulation, namely human leukocyte antigen-DR isotype (HLA-DR), and programmed death ligands 1 (PD-L1) and 2 (PD-L2) were measured using flow cytometry. RESULTS: The inhibition of endocannabinoid receptors together with the proinflammatory effect of TNF-α resulted in increased HLA-DR expression in stem cells from human exfoliated deciduous teeth, as well as, in these cells acquiring an anti-inflammatory profile by enhancing the expression of PD-L1 and PD-L2. CONCLUSION: Stem cells from human exfoliated deciduous teeth respond to the endocannabinoid system and TNF-α by altering key immune response molecules. Inhibition of endocannabinoid receptors and TNF-α led to an increase in HLA-DR, PD-L1, and PD-L2 levels in stem cells from human exfoliated deciduous teeth. This study shows the interaction between mesenchymal stromal cells and the immune and endocannabinoid systems.

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This study describes the extraction and identification by electrophoretic and spectrometric techniques of protease inhibitor from the medicinal plant Alocasia macrorrhizos as well as investigates their immunomodulatory properties and cell viability. The A. macrorrhizos tubers were subjected to protease inhibitor extractions and characterised using SDS-PAGE and MALDI-TOF. The protein extracts were assessed for activities trypsin inhibition stoichiometry, haemagglutinating, cell viability, NO and TNF-α production inhibition. Concerning the protease inhibitors analysis through SDS-PAGE, the results showed two bands with 11 and 24 kDa, and the MS analysis detected the ions more intense of m/z 4276.795 and 8563.361 in the roasted protein extract. The IC50 of trypsin inhibition was 0.119 and 0.302 mg L-1 in the roasted and crude tuber, respectively. The protease inhibitors extract from the roasted tubers showed a reduction in the production of NO and TNF-α at concentrations lower than 100 µg mL-1, without a reduction in cell viability.

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In traditional Brazilian medicine, tubers extracts from Alocasia macrorrhizos are widely used in the treatment of skin pigmentation disorder. However, studies that evaluate its benefits in the treatment of this disorder are non-existent. Thus, this work aims to investigate the bioactivity of A. macrorrhizos extracts in cell culture and murine model of Vitiligo and correlating with its phenolic profile. The metabolic profiling from the bioactive extracts was obtained by LC-DAD-MS, FTIR, NMR, and CE-UV. The murine model of Vitiligo was induced with 5% hydroquinone in C57BL/6 male mice, which were treated or not with 100 mg/kg of roasted tuber aqueous extract. In Vitiligo model assay was observed hair follicle repigmentation and reduction of the epidermal layer thickness at the histopathological level, in the animals treated with aqueous extract of roasted tubers. The present study provides new molecular insight and scientific evidence on the potential utility of the extract of A. macrorrhizos against Vitiligo.

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Siparuna brasiliensis is a medicinal plant widely used by indigenous communities of the Amazon rainforest to treat inflammatory diseases and related pathologies. Considering its ethnopharmacological application, it constitutes an important source of biologically active molecules in the development of anti-inflammatory drugs. This study describes a dereplication methodology of the bioactive extract from S. brasiliensis leaves and the evaluation of the anti-inflammatory potential in an in vivo inflammatory model with mice of the BALB/c lineage and in vitro using cell lines, as well as determining the production of an inflammatory mediator. From their charge-to-mass ratios (m/z) and elemental composition obtained through Ultrahigh-resolution mass spectrometry analysis by ESI(-)-Orbitrap MS and chromatographic profile by RP-HPLC-PDA, it was possible to annotate polyphenols with anti-inflammatory properties classified as flavonoids and organic acids. The administration of the extract significantly inhibited carrageenan-induced paw edema and showed effects similar to those of drug dexamethasone without affecting cell viability.

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ABSTRACT Objective To verify the involvement of the endocannabinoid system in the immunomodulatory profile of stem cells from human exfoliated deciduous teeth, in the presence or absence of TNF-α, and agonist and antagonists of CB1 and CB2. Methods Stem cells from human exfoliated deciduous teeth were cultured in the presence or absence of an agonist, anandamide, and two antagonists, AM251 and SR144528, of CB1 and CB2 receptors, with or without TNF-α stimulation. For analysis of immunomodulation, surface molecules linked to immunomodulation, namely human leukocyte antigen-DR isotype (HLA-DR), and programmed death ligands 1 (PD-L1) and 2 (PD-L2) were measured using flow cytometry. Results The inhibition of endocannabinoid receptors together with the proinflammatory effect of TNF-α resulted in increased HLA-DR expression in stem cells from human exfoliated deciduous teeth, as well as, in these cells acquiring an anti-inflammatory profile by enhancing the expression of PD-L1 and PD-L2. Conclusion Stem cells from human exfoliated deciduous teeth respond to the endocannabinoid system and TNF-α by altering key immune response molecules.

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Nanoparticles (NPs) of α-MnO2 have high applicability in photoelectrochemical, heterogeneous photocatalysis, optical switching, and disinfection processes. To widen this panorama about MnO2 NPs, the formation of this material by laser ablation and deposition by dip-coating on fluorine-doped tin oxide (FTO), were considered in this study. The optical, spectroscopic, electrochemical characterization, and the evaluation of the antimicrobial activity, plus the photocatalytic response, were measured herein in colloidal media and deposited. For the deposition of NPs on FTO sheet, an anode is produced with a pseudocapacitive behavior, and 2.82 eV of band gap (GAP) in comparison with colloidal NPs for a value of 3.84 eV. Both colloidal suspension and deposited NPs have intrinsic antibacterial activity against two representative microorganisms (E. coli and S. aureus), and this biological activity was significantly enhanced in the presence of UVA light, indicating photocatalytic activity of the material. Thus, both the colloidal suspension and deposited NPs can act as disinfecting agents themselves or via light activation. However, an antibacterial behavior different for E. coli and S. aureus was observed, in function of the aggregation state, obtaining total E. coli disinfection at 30 min for deposited samples on FTO.

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OBJECTIVES: To determine the time to reverse transcription-polymerase chain reaction (RT-PCR) negativity after the first positive RT-PCR test, factors associated with longer time to RT-PCR negativity, proportion of children seroconverting after proven severe acute respiratory syndrome coronavirus 2 infection, and factors associated with the lack of seroconversion. STUDY DESIGN: The Epidemiological Study of Coronavirus in Children of the Spanish Society of Pediatrics is a multicenter study conducted in Spanish children to assess the characteristics of coronavirus disease 2019. In a subset of patients, 3 serial RT-PCR tests on nasopharyngeal swab specimens were performed after the first RT-PCR test, and immunoglobulin G serology for severe acute respiratory syndrome coronavirus 2 antibodies was performed in the acute and follow-up (<14 and ≥14 days after diagnosis) phase. RESULTS: In total, 324 patients were included in the study. The median time to RT-PCR negativity was 17 days (IQR, 8-29 days), and 35% of patients remained positive more than 4 weeks after the first RT-PCR test. The probability of RT-PCR negativity did not differ across groups defined by sex, disease severity, immunosuppressive drugs, or clinical phenotype. Globally, 24% of children failed to seroconvert after infection. Seroconversion was associated with hospitalization, persistence of RT-PCR positivity, and days of fever. CONCLUSIONS: Time to RT-PCR negativity was long, regardless of the severity of symptoms or other patient features. This finding should be considered when interpreting RT-PCR results in a child with symptoms, especially those with mild symptoms. Seroprevalence and postimmunization studies should consider that 11 in 4 infected children fail to seroconvert.

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BACKGROUND: The short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) is a popular instrument used to assess quality of life. The objective of this study was to evaluate the following psychometric properties: structural validity, convergent validity, internal consistency, and measurement invariance across sex of the WHOQOL-BREF in a sample of Ecuadorian adults. METHODS: We used a sample of undergraduates (n = 987) to assess the WHOQOL-BREF original four-factor structure, a model with correlated factors, a hierarchical model, and two models resulting from the exploratory factor analysis and exploratory graph analysis. All the models were evaluated using confirmatory factor analysis. RESULTS: The results of the exploratory factor analysis and exploratory graph analysis suggest that the items are organized into four factors, although differently from the original version and the orthogonality assumption is not maintained. The confirmatory factor analysis shows that the original WHOQOL-BREF structure with correlated factors presents adequate psychometric properties. However, we propose a four-factor structure that has the best psychometric properties and adequate internal consistency. The results of the measurement invariance show that strict and strong invariance is achieved between men and women. Convergent validity analysis reveals moderate correlations with self-esteem, resilience, and social support. CONCLUSIONS: Despite the original version of the WHOQOL-BREF with correlated factors has acceptable psychometric properties in the Ecuadorian context, we propose a version with a different organization of its items, which is consistent with the findings of other investigations.

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Poor communication contributes to morbidity and mortality, not only in general medical care but also at the end oflife. This leads to issues relating to symptom control and quality of care. As part of an international project focused on bereaved relatives' perceptions about quality of end-of-life care, we undertook a quality improvement (QI) project in a general hospital in Córdoba city, Argentina.By using two iterative QI cycles, we launched an educational process and introduced a clinical mnemonic tool, I-PASS, during ward handovers. The introduction of the handover tool was intended to improve out-of-hours care.Our clinical outcome measure was ensuring comfort in at least 60% of dying patients, as perceived by family carers, during night shifts in an oncology ward during the project period (March-May 2019). As process-based measures, we selected the proportion of staff completing the I-PASS course (target 60%) and using I-PASS in at least 60% of handovers. Participatory action research was the chosen method.During the study period, 13/16 dying patients were included. We received 23 reports from family carers about the level of patient comfort during the previous night.Sixty-five per cent of healthcare professionals completed the I-PASS training. The percentage of completed handovers increased from 60% in the first Plan-Do-Study-Act (PDSA) cycle to 68% in the second one.The proportion of positive reports about patient comfort increased from 63% (end of the first PDSA cycle) to 87% (last iterative analysis after 3 months). Moreover, positive responses to 'Did doctors and nurses do enough for the patient to be comfortable during the night?' increased from 75% to 100% between the first and the second QI cycle.In conclusion, we achieved the successful introduction and staff training for use of the I-PASS tool. This led to improved perceptions by family carers, about comfort for dying patients.

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This study aims to evaluate the analgesic and modulating effect of Curcuma longa and Miconia albicans herbal medicines in knee's osteoarthritis (OA) treatment. This longitudinal study evaluated 24 patients with OA. The patients were divided into three groups: ibuprofen (1200 mg/day), C. longa (1000 mg/day) and M. albicans (1000 mg/day). The medications were applied orally for 30 days. The synovial fluid of the knee joint was collect at the first (day 0) and the last medical (day 30) consultation. The groups treated with herbal medicines presented the same results when compared to Ibuprofen. The comparison of the means of Total WOMAC for M. albicans before and after treatment presented a statistically significant difference (mean day 0 = 57.19; mean day 30 = 31.02) as well as variation of Total WOMAC for C. longa (mean day 0 = 54.79; mean day 30 = 37.08). The WOMAC Total and the VASP were compared, it was found that there was a significant decrease in the means in the C. longa and M. albicans groups, as well as in the Ibuprofen group after treatment. The study demonstrated that the treatment of knee OA with C. longa or M. albicans positively interferes with patients pain and functionality, decreased WOMAC and VASP scores, leading to functional improvement of these patients. This is the first clinical study demonstrating the analgesic and anti-inflammatory effect on knee osteoarthritis from M. albicans comparable to Ibuprofen drug.

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This work aimed to obtain and characterize protease inhibitors from A. colubrina leaves and evaluate their potential as inflammatory mediator and cell viability. The protein extract was analyzed and characterized by SDS-PAGE, RP-HPLC-PDA, MALDI-TOF/MS and Zeta potential. Bioassays were conducted in order to evaluate the cell viability in RAW 264.7, in vitro (NO and TNF-α production inhibition) and in vivo anti-inflammatory potential, inhibition rate of trypsin and hemagglutination activity from protein extract. The results revealed the presence of bands at 14, 21 and 30 kDa in SDS-PAGE, the RP-HPLC-PDA analysis showed peaks at 12, 13, 28 and 40 minutes and MALDI-TOF/MS showed peaks with 3.4, 4.7, 5.6, 9.4 and 11.2 kDa. The protein extracts presented enzymatic activity inhibition of trypsin (IC50 59.2 µgmL-1), did not show any cytotoxicity to RAW264.7 cells, hemagglutination 8HU and insignificant reduction in NO and TNF-α production and reduced anti-inflammatory potential in vivo compared to dexamethasone.

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Our objective is to investigate the phytochemical components, antioxidant capacity and in vitro and in vivo anti-inflammatory action from Cecropia hololeuca bark aqueous extract (AECh). The chemical characterization of AECh was performed through CE-UV, FTIR and NMR Spectroscopy. In vitro assays were performed with the AECh on murine macrophages J774A.1 cells in order to analyse cell viability, NO, TNF-α and IL-1ß productions and the in vivo anti-inflammatory potential in acute carrageenan paw oedema in mice. The AECh showed a decrease in the production of NO, TNF-α and IL-1ß, without altering the cell viability and reduction of the paw thickness in the 2nd, 3rd and 4th hour. The extract presented 72% free radical scavenging, 0.60% flavonoid content and showed the presence of gallic acid, caffeic acid and catechin as major constituents. The C. hololeuca bark extract showed important antioxidant and anti-inflammatory activity, emphasizing the industrial and pharmacological potential of this plant.

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The present study highlights the antioxidant and anti-inflammatory activities from Anadenanthera colubrina leaves ethanolic extract (EEAc) and its phytochemical profile. The chemical profile of EEAc was determined and in vitro free radical scavenging potential, cell viability in RAW 264.7 and in vitro and in vivo anti-inflammatory activity were evaluated. The analysis of EEAc showed several phenolic compounds such as tannins and phenolic acids. The high antioxidant potential observed is possibly due to its high phenolic content. The EEAc (500 mg kg-1) showed an in vivo effect at the same level of dexamethasone; in vitro, at 50 µg mL-1, inhibited approximately 80% of nitric oxide production concentration, showed an inhibition of more than 50% of TNF-α production and presented high cell viability. The results show that A. colubrina leaves are an important source of phytochemicals that possesses antioxidant and anti-inflammatory properties.

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RESUMEN Los síndromes paraneoplásicos neurológicos se presentan en menos del 1% de los tumores sólidos y son infrecuentes en linfomas. Se asocian a tumores con alta actividad biológica y condicionan deterioro funcional y discapacidad. La dermatomiositis se asocia a cáncer, por tanto obliga al estudio de neoplasias ocultas; su diagnóstico como síndrome paraneoplásico se establece con criterios específicos. El pronóstico funcional depende del diagnóstico oportuno, control del cáncer y de la regulación de la respuesta inmunológica. Se presenta el caso de una mujer de 65 años con dermatomiositis en el curso de un linfoma B marginal variante convencional de primario cutáneo.

ABSTRACT Neurological paraneoplastic syndromes occur in less than 1% of solid tumours and are uncommon in lymphomas. They are related to tumours with high biological activity and cause functional impairment and disability. Dermatomyositis is associated with cancer, and requires the study of hidden neoplasms. Its diagnosis as a paraneoplastic syndrome is established with specific criteria. Functional prognosis depends on early diagnosis, cancer control, and regulation of the immune response. The case is presented of a 65 year-old woman with dermatomyositis during the course of a conventional variant of a primary cutaneous B marginal lymphoma.

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Background: The incidence of metabolic disorders in dairy cows has increased as a result of intensive production practicesand genetic selection for milk yield. Among such disorders, liver lipidosis is very frequently observed and has significantnegative effects on cow health and milk yield. Severe energy supply deficit causes high fat mobilization, resulting in rapidbody condition loss and liver lipid infiltration, which cannot always be detected by known blood biochemical indicators.The main objective of the study was to determine possible associations of blood biochemical parameters with liver lipidinfiltration severity in high-yield multiparous Holstein cows along prepartum and postpartum periods.Materials, Methods & Results: Fifty-four high-yield Holstein cows from a herd managed in a free-stall system in thenorthwest region of the state of Rio Grande do Sul, Brazil were evaluated. Cows were divided in two groups accordingto their physiological status. Group 1 included 19 prepartum cows, with an average milk yield of 44.7 L/d in the previouslactation, and 2.8 average parity, and Group 2 included 35 postpartum cows, with an average milk yield of 46.8 L/d in theprevious lactation, and 2.5 average parity. The farm produced 10,000 kg milk per year, containing 3.5% of fat, 3.2% ofprotein and 4.7% of lactose. Total cholesterol (CH), plasma triglycerides (TGp), beta-hydroxybutyrate (BHB), albumin(ALB), non-esterified free fatty acids (NEFA) levels, and aspartate aminotransferase (AST) and creatine kinase (CK) activities were analyzed in the plasma and liver triglycerides (TGl) levels were determined in liver tissue samples. The SPSSstatistical software was used for the statistical analyses. The obtained data were analyzed for normality by the Shapiro-Wilktest and for homoscedasticity by Bartlett test. Data were submitted to analysis of variance, and means were compared bythe...(AU)

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Background: The incidence of metabolic disorders in dairy cows has increased as a result of intensive production practicesand genetic selection for milk yield. Among such disorders, liver lipidosis is very frequently observed and has significantnegative effects on cow health and milk yield. Severe energy supply deficit causes high fat mobilization, resulting in rapidbody condition loss and liver lipid infiltration, which cannot always be detected by known blood biochemical indicators.The main objective of the study was to determine possible associations of blood biochemical parameters with liver lipidinfiltration severity in high-yield multiparous Holstein cows along prepartum and postpartum periods.Materials, Methods & Results: Fifty-four high-yield Holstein cows from a herd managed in a free-stall system in thenorthwest region of the state of Rio Grande do Sul, Brazil were evaluated. Cows were divided in two groups accordingto their physiological status. Group 1 included 19 prepartum cows, with an average milk yield of 44.7 L/d in the previouslactation, and 2.8 average parity, and Group 2 included 35 postpartum cows, with an average milk yield of 46.8 L/d in theprevious lactation, and 2.5 average parity. The farm produced 10,000 kg milk per year, containing 3.5% of fat, 3.2% ofprotein and 4.7% of lactose. Total cholesterol (CH), plasma triglycerides (TGp), beta-hydroxybutyrate (BHB), albumin(ALB), non-esterified free fatty acids (NEFA) levels, and aspartate aminotransferase (AST) and creatine kinase (CK) activities were analyzed in the plasma and liver triglycerides (TGl) levels were determined in liver tissue samples. The SPSSstatistical software was used for the statistical analyses. The obtained data were analyzed for normality by the Shapiro-Wilktest and for homoscedasticity by Bartlett test. Data were submitted to analysis of variance, and means were compared bythe...

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El hemangiolinfangioma es una malformación vascular de rara ocurrencia. Posee componentes mixtos, venosos y linfáticos, y su manejo es limitado en casos de gran extensión. Se presenta el caso de un hombre con alteración vascular de bajo flujo, de predominio linfático, con extensión intrabdominal, retroperitoneal, pélvica y de miembros inferiores.

Hemangiolymphangioma is a vascular malformation of rare occurrence. It has mixed venous and lymphatic components and its management is limited in cases of large extension. We present the case of a man with low-flow vascular alteration, predominantly lymphatic, with intra-abdominal, retroperitoneal, pelvic and lower limb extension.

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La aparición de la pandemia por Covid-19, su alto contagio e impacto en la salud de poblaciones vulnerables y la necesidad de distanciamiento social, obligó a adaptar rápidamente los procesos de atención ambulatoria a pacientes por medio de herramientas tecnológicas con eventos de atención no presencial (teleconsulta). El propósito de este artículo es revisarla información más relevante sobre el uso de la telemedicina y su impacto actual

The emergence of the Covid-19 pandemic, its high contagion and impact on the health of vulnerable populations and the need for social distancing, forced the rapid adaptation of outpatient care processes by means of technological tools with non-face-to-face care events (teleconsultation). The purpose of this article is to review the most relevant information on the use of telemedicine and its current impact.

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En diciembre de 2019 en China, inicia una de las pandemias más complejas del último siglo. En efecto, la infección por Sars-CoV-2 o Covid-19, como fue denominada por la Organización Mundial de la Salud, es sin duda una emergencia en salud pública que ha requerido implementar modificaciones de los sistemas de salud en el mundo para su atención. Los síntomas respiratorios son la base de las principales complicaciones de esta infección; sin embargo, se encuentra disponible información relevante sobre las manifestaciones neurológicas asociadas al Sars-CoV-2, en especial con relación al compromiso del sistema nervioso central (SNC); por el contrario, los estudios sobre el impacto del nervio periférico son más escasos. La presente revisión se centra en las manifestaciones neurológicas periféricas asociadas al Covid-19.

In December 2019 in China, one of the most complex pandemics of the last century begins. Indeed, the Sars-CoV-2 or Covid-19 infection, as it was named by the World Health Organization, is undoubtedly a public health emergency that has required the implementation of modifications in the world's health systems for its care. Respiratory symptoms are the basis of the main complications of this infection; however, relevant information is available on the neurological manifestations associated with Sars-CoV-2, especially in relation to central nervous system (CNS) involvement; in contrast, studies on the impact of the peripheral nerve are scarcer. The present review focuses on the peripheral neurological manifestations associated with Covid-19.

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This paper evaluates the factor structure, reliability and validity of the gratitude scale (GQ-6) of McCullough, Emmons and Tsang (2002) and the five-item version proposed by Chen et al. (2009). Results of a sample of 1112 adults show that the fiveitem version has excellent internal consistency (α=.926; ω=.891; GLB=.913); high and significant factor loadings (greater than .8; p<.01), and excellent goodness of fit indexes (χ²(5)=23.837, p<.001; CFI=.997; TLI=.995; RMSEA=.082, p=.045; SRMSR=.035; WRMSR=.837). The criterion validity was evaluated applying subscales of the PERMA-Profiler: positive emotions (ρ=.5702, p=.021) and negative emotions (ρ=-.1786, p=.0316). Finally, we find psychometric equivalence between the sex of the participants. In conclusion, the five-item questionnaire is valid and reliable in the Ecuadorian context. (AU)

Este estudo avalia a estrutura fatorial, a confiabilidade e a validade da Escala de Gratidão (GQ-6) de McCullough, Emmons e Tsang (2002) e a versão de cinco itens proposta por Chen et al. (2009). Resultados de uma amostra de 1.112 adultos mostram que a versão de cinco itens tem excelente consistência interna (α=0,926; ω=0,891; GLB=0,913); cargas fatoriais altas e significativas (maior que 0,8; p<0,01), e excelentes índices de qualidade de ajuste (χ²(5)=23,837, p<0,001; CFI=0,997; TLI=0,995; RMSEA=0,082, p=0,045; SRMSR=0,035; WRMSR=0,837). A validade de critério foi avaliada aplicando-se subescalas do PERMA-Profiler: emoções positivas (ρ=0,5702, p=0,021) e emoções negativas (ρ=-0,1786, p=0,0316). Finalmente, encontra-se equivalência psicométrica entre o sexo dos participantes. Em conclusão, o questionário de cinco itens é válido e confiável no contexto equatoriano. (AU)

Este estudio evalúa la estructura factorial, la confiabilidad y la validez de la escala de gratitud (GQ-6) de McCullough, Emmons y Tsang (2002) y la versión de cinco ítems propuesta por Chen et al. (2009). Resultados de una muestra de 1112 adultos indican que la versión de cinco ítems tiene excelente consistencia interna (α=.926; ω=.891; GLB=.913); cargas factoriales altas y significativas (mayores a .8; p < .01), y excelentes índices de calidad de ajuste (χ²(5)=23.837, p<.001; CFI=.997; TLI=.995; RMSEA=.082, p=.045; SRMSR=.035; WRMSR=.837). La validez de criterio se evaluó aplicando subescalas del PERMA-Profiler: emociones positivas (ρ=.5702, p=.021) y emociones negativas (ρ=-.1786, p=.0316). Finalmente, se ha encontrado equivalencia psicométrica entre el sexo de los participantes. En conclusión, el cuestionario de cinco ítems es válido y fiable en el contexto ecuatoriano. (AU)

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